Individual provider Active NPI

Martin G Bertrand

  • Occupational Therapy Assistant
  • Orlando, FL
National Provider Identifier
1508334079
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
16890 Issued in FL
Practice address
8415 Diamond Cove Cir
Orlando, FL 32836-6015
Phone
(904) 383-5427
NPI assigned
Nov 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Occupational Therapy Assistant 224Z00000X 16890 FL Primary

Addresses

Primary practice location

8415 Diamond Cove Cir
Orlando, FL 32836-6015

Mailing address

8415 Diamond Cove Cir
Orlando, FL 32836-6015
Phone (904) 383-5427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16890FLMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1508334079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 DIAMOND COVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328366015",
            "telephone_number": "904-383-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 DIAMOND COVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328366015",
            "telephone_number": "904-383-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "MARTIN",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "16890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.